INTRODUCTION There is controversy regarding the clinical T category of lung adenocarcinomas that manifest as part-solid nodules (PSNs). We aimed to validate the clinical T category and to evaluate the independent prognostic role of the nodule type (i.e., part-solid vs. solid). METHODS We retrospectively evaluated the prognostic value of clinico-radiological factors on the overall survival of patients with clinical stage IA lung adenocarcinomas that were resected between 2008 and 2014. Clinical T category, nodule type, and their interaction term were included in the multivariable Cox regression analysis with other variables. In addition, a mixture cure model analysis was performed to investigate the association between the covariates and long-term survival. RESULTS A total of 744 patients (420 women; 362 PSNs; median age, 63 years) were included. The multivariable-adjusted HR of the nodule type was not significant (1.30; 95% CI: 0.80, 2.10; P=0.291). However, the clinical T categories were significantly associated with overall survival (HR of cT1b, 2.33 [95% CI: 1.07, 5.06; P=0.033]; HR of cT1c, 5.74 [95% CI: 2.51, 13.12; P<0.001]). There were no interactions between the nodule type and the clinical T categories (all P>0.05). The multivariable mixture cure model revealed that solid nodules were associated with a decreased probability of long-term survival (OR, 0.40; 95% CI: 0.18, 0.92; P=0.030). Clinical T1c was also a negative predictor of long-term survival (OR, 0.26; 95% CI: 0.07, 0.94; P=0.040). CONCLUSIONS The clinical T categorization system is valid for PSNs and solid nodules. Nevertheless, PSNs are a prognostic factor associated with long-term survival.

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第八版临床 T 分类系统对临床 IA 期切除肺腺癌的验证：毛玻璃样混浊成分的预后意义

引言 关于表现为部分实性结节 (PSN) 的肺腺癌的临床 T 分类存在争议。我们旨在验证临床 T 类别并评估结节类型（即部分实性与实性）的独立预后作用。方法 我们回顾性评估临床放射学因素对 2008 年至 2014 年间切除的临床 IA 期肺腺癌患者总生存期的预后价值。临床 T 类别、结节类型及其交互项被纳入多变量 Cox 回归与其他变量的分析。此外，还进行了混合治愈模型分析，以研究协变量与长期生存之间的关联。结果 共纳入 744 名患者（420 名女性；362 名 PSN；中位年龄 63 岁）。结节类型的多变量调整 HR 不显着（1.30；95% CI：0.80、2.10；P=0.291）。然而，临床 T 类别与总生存期显着相关（cT1b 的 HR，2.33 [95% CI：1.07、5.06；P=0.033]；cT1c 的 HR，5.74 [95% CI：2.51、13.12；P<0.001] ）。结节类型与临床 T 分类之间无交互作用（均 P>0.05）。多变量混合物治愈模型显示，实性结节与长期生存概率降低相关（OR，0.40；95% CI：0.18，0.92；P=0.030）。临床 T1c 也是长期生存的负向预测因子（OR，0.26；95% CI：0.07, 0.94；P=0.040）。结论 临床 T 分类系统适用于 PSN 和实性结节。尽管如此，PSNs 是与长期生存相关的预后因素。